Canada’s federal government is launching an initiative to combat antibiotic resistant bacteria. This is a very sensible thing to do, given how bacterial evolution is creating resistant strains at a higher rate than the one at which we are inventing new antibiotics. MRSA and its relatives could well signal a return to a world in which morbidity and mortality from bacterial illness start shifting back towards the levels prevalent before antibiotics were widely available.
We largely have ourselves to blame for the existence of these bugs. Every time a doctor prescribes unnecessary antibiotics in order to get a patient out of their office, we give them another chance to get stronger. The same goes for when a patient stops taking an antibiotic prescription when they feel better, rather than when it runs out, potentially leaving a few of the most resistant bugs behind to infect others. The same is true for all the ‘antibacterial’ soaps and cleaning products out there. Putting triclosan in soap is pretty poor prioritization. Outside the body, it makes the most sense to kill bugs with things they cannot evolve resistance to: like alcohol or bleach. Using the precious chemicals that kill them but not us to clean countertops is just bad thinking. Finally, there is the antibiotic-factory farming connection discussed extensively here before.
The federal plan involves a number of prudent steps, many of them specifically targeted to MRSA and Clostridium difficile. These include more active patient screening, better sanitization of hospital rooms, use of prophylactics like gloves and masks, and the isolation of patients with resistant strains. Given that there were 13,458 MRSA infections in Ontario hospitals in 2006, it seems that such an initiative is overdue. It would be exceedingly tragic if we comprehensively undermined one of the greatest discoveries in the history of medicine through carelessness and neglect.